Technique for Reconstruction of the Proximal Tibiofibular Joint Using Biceps Femoris and Iliotibial Band Autograft With Suture Tape Augmentation

Abstract

Background: Proximal tibiofibular joint instability is an uncommon condition that can occur in acute traumatic dislocations, chronic or recurrent dislocations, and atraumatic dislocations. A variety of procedures have been described for treatment of this condition including fibular head resection, arthrodesis, suture button stabilization, and soft tissue reconstruction. Indications: The initial management consists of conservative measures such as activity modification, use of a supportive strap, and physical therapy. When nonoperative management fails, surgical management is indicated. Technique Description: To optimize surgical technique and patient outcomes, a previously described reconstruction technique was modified with reinforcement of suture tape augmentation and decreased invasiveness. Results: This technique has several advantages including a smaller incision with shorter iliotibial band (ITB) and biceps femoris tendon (BFT) grafts and safer posterior to anterior drilling as opposed to anterior to posterior directed drilling. Discussion/Conclusion: The authors believe there is increased stability with this reconstruction technique due to the added suture tape augmentation in addition to the biologic healing potential provided by the ITB and BFT autografts. The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.